How do you manage a cervical cancer patient on anti-coagulation for pulmonary embolism requiring interstitial brachytherapy boost?
Is anticoagulation for PE an absolute or relative contraindication to IS brachy? Would you favor placement of IVC filter prior to procedure?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
Have done with IVC filter and switch to heparin days prior to the procedure so that can hold anti coagulant for the procedure and epidural placement for analgesia.
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Mednet MemberInvited Expert
Radiation Oncology · Abramson Cancer Center, University of Pennsylvania
Answered on
Not a contraindication. We bridge with either heparin or more often lovenox in 2 days prior to the procedure if the patient is on DOAC.
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